胃癌患者化疗后生活质量的影响因素及个体化营养干预影响

目的探究胃癌患者化疗后生活质量的影响因素及个体化营养干预的作用。方法选取2017年1月至2019年1月于首都医科大学附属北京康复医院就诊的患者100例,按照营养干预方式的不同,分为观察组与对照组,每组50例,观察组患者采取个体化营养干预,对照组采取常规营养干预。比较化疗前后两组患者体质指数(BMI)、营养指数、外周血指标变化,两组患者并发症发生概率及生活质量评分比较,并利用多因素Logistic回归分析影响胃癌患者化疗后生活质量的因素。结果观察组患者经个体化营养干预后BMI、营养指数(PNI)、前白蛋白(PALB)、血清白蛋白(ALB)及转铁蛋白(TRF)明显高于对照组,并且两组患者经营养干预后,与化疗前比较BMI呈现升高的趋势,INQ、PALB、ALB及TRF等均呈现降低的趋势,差异具有统计学意义(P<0.05);观察组患者出现并发症的概率明显低于对照组(χ^2=4.336,P=0.037);化疗后两组患者5个功能领域、总体健康状态评分明显升高,且观察组患者升高比对照组明显,而3个症状领域评分则呈现降低的趋势(P<0.05);Logistic回归分析发现发生淋巴结转移、家庭月收入≤5000元、合并器官切除、居住地为农村及营养不良是影响胃癌患者化疗后生活质量的主要因素。结论淋巴结转移、工作情况、合并器官切除、手术范围及营养状况对胃癌患者化疗后生活质量有重要影响,个体化营养干预能够促进胃癌患者化疗后身体指标改善,有利于提高患者的生存质量。

Study on the intervention of individualized nutrition therapy in patients with postoperative chemotherapy of gastric cancer and the analysis of factors affecting their quality of life

Objective To investigate the influencing factors of quality of life and individualized nutritional intervention in patients with gastric cancer after chemotherapy.Methods From January 2017 to January 2019,100 patients admitted to Beijing Rehabilitation Hospital Affiliated to Capital Medical University were divided into the observation group(n=50)and the control group(n=50)given different nutritional intervention.The patients in the observation group were treated with individualized nutrition intervention,while the control group was treated with routine nutrition intervention.The changes of body mass index,nutrition index and peripheral blood index,the probability of complications and the score of quality of life in the two groups were compared before and after chemotherapy,and the factors affecting the quality of life of patients with gastric cancer after chemotherapy were analyzed by multivariate Logistic regression analysis.Results The body mass index(BMI),nutrition index(PNI),prealbumin(PALB),serum albumin(ALB)and transferrin(TRF)were significantly higher in the observation group than those in the control group.After nutritional intervention,BMI and TRF in the two groups showed an upward trend compared with those before chemotherapy,and the difference was statistically significant(P<0.05).The probability of complications was significantly lower in the observation group than in the control group.(χ^2=4.336,P=0.037).After chemotherapy,the scores of overall health status in the two groups were significantly higher than those in the control group,while the scores in the three symptom areas in the observation group were significantly higher than those in the control group(P<0.05).Logistic regression analysis found that lymph node metastasis,monthly household income≤5000 yuan,combined organ resection,rural residence and malnutrition were the main factors affecting the quality of life of gastric cancer patients after chemotherapy.Conclusion Lymph node metastasis,working condition,combined organ resection,surgical scope and nutritional status have important effects on the quality of life of patients with gastric cancer after chemotherapy.Individualized nutrition intervention can promote the improvement of physical indexes of patients with gastric cancer after chemotherapy,which is beneficial to improve the quality of life of patients with gastric cancer.